[Chronic viral hepatitis in St.Petersburg].

Morbidity data on chronic viral hepatitis including cirrhotic stages of disease and lethality indexes in St. Petersburg are provided. The necessity of isolation in ICD- 10 and statistical accounting of chronic viral hepatitis diagnosis with outcome into cirrhosis (cirrhotic stage) is shown. During use of viral etiology liver cirrhosis diagnosis the disease is registered in the structure of liver diseases which does not allow to have data on unfavorable outcomes of chronic viral hepatitis and for complete morbidity accounting.

[Sporadic and group imported cases of hepatitis E in St. Petersburg].

AIM: Carry out retrospective clinical-epidemiological analysis of sporadic and group cases of acute HE morbidity in St. Petersburg (2000 - 2012). MATERIALS AND METHODS; Medical histories of 11 patients with sporadic morbidity (9 males and 2 females, average age 36 +/- 18) and 13 patients involved in group HE morbidity were analyzed. Acute hepatitis E diagnosis was established based on common clinical-epidemiological criteria confirmed by results of biochemical study and data of objective examination. Hepatitis E etiological membership was confirmed by detection in patient blood sera of specific marker of infection--anti-HEV G and M classes with laboratory exclusion of hepatitis A, B and C. RESULTS: Study of epidemiological anamnesis of patients showed that 8 of them were migrants from countries with tropical and subtropical climate. 3 patients were residents of St. Petersburg. In the end of December 2011 and in January 2012 a group HE morbidity was registered among those who had arrived to study in St. Petersburg from India (Mumbai) in a group exceeding 200 individuals. Clinical characteristic of acute HE during sporadic and group morbidity is given. CONCLUSION: The presence of sporadic and group HE morbidity in St. Petersburg indicates the necessity to register these situation in organization of protection of the territory of Russia from endogenous HE.

[Clinical and economic expedience of ertapenem therapy of complicated urinary tract infection].

Clinical and economic investigation of various antibiotics use in the treatment of complicated urinary tract infection (CUTI) was performed under the Russian economic environment. The drugs of comparison were ertapenem, ceftriaxone and levofloxacin. Direct costs and their structure were shown, and the cost efficiency was calculated. Alternative analysis and one-side susceptibility analysis were performed. In complicated urinary tract infections when the major pathogens were Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis it was clinically and economically reasonable to start the treatment with ceftriaxone or ertapenem, while levofloxacin could be an alternative strategy. When the effects of the acquired resistance on the treatment effectiveness were evaluated (SIS model) it was shown that the pathogens susceptibility to ertapenem was preserved for a significantly longer time than that to ceftriaxone or levofloxacin (60 months). Such a parameter may serve as an additional evidence of the reasonable use of ertapenem as the starting treatment of CUTI.

[Predictive value of variability of the laboratory indices in the development of premature aging].

Diagnostics of those or other pathological processes is connected with an estimation of deviations of corresponding laboratory indexes from their reference values. Results of the research enable to use the indexes of individual variability of laboratory tests as a criterion of individual resistance, which has a prognosis value in studying of age pathology. It also essentially expands ideas about activation of the peroxide oxidation of the lipids as the basic trigger factor of the accelerated aging.

[Brain natriuretic peptide detection in patients with chronic heart failure of elderly and senile age].

This article describes the diagnostic possibilities of research of NT-BNP level in blood of the patients of elderly and senile age with congestive heart failure. Statistically significant correlation between BNP concentration and a functional class of heart insufficiency is revealed. Definition of BNP level enables to diagnose differentially the difficult forms of congestive heart failure.

[The topical problems of morphological diagnosis and the pathomorphism of HIV infection].

The paper analyzes the frequency of admissions to the S. P. Botkin Clinical Infectious Hospital and the City AIDS Center among patients with HIV infection and the structure of fatal outcomes. It is concluded that there is a considerable increase in mortality and the number of patients needing hospitalization. The dead HIV-infected patients autopsied at the Unit of Morbid Anatomy, S. P. Botkin Hospital, in the past years are characterized in detail. The topical problems of HIV infection the solution of which require the participation of pathomorphologists are discussed.

[Hepatoprotective activity of remaxol in patients with chronic hepatic disorders].

This milticentre randomized clinical study of the efficiency of remaxol infusion solution (hepatoprotective medicine for chronic liver dysfunction) included 494 patients with chronic hepatitis B and C. 294 of them staying in 7 clinics were given remaxol and 200 ones received placebo. Randomization was achieved by the envelope method. A detailed description of clinical and laboratory characteristics of the diseases is presented. Effects of remaxol vs placebo on the functional activity of affected liver are discussed. Results of laboratory and clinical analysis indicate that mechanism of remaxol action is based on hepatoprotective, antioxidative, and anticholestatic activities of the drug.

[Effects of intracerebroventricular administration of a caspase-3 inhibitor Z-DEVD-FMK on behavior of rats].

Rats received intracerebroventricular injections of z-DEVD-FMK (caspase-3 inhibitor) or z-FA-FMK (control peptide) in a dose of 3 nmol. Administration of z-DEVD-FMK significantly decreased the number of avoidance reactions in some blocks of trials in active avoidance (shuttle box) learning. However, only slight effect of the caspase inhibitor across the session was found. Z-DEVD-FMK impaired development of some essential components of the two-way active avoidance performance, such as escape reaction, conditioned fear reaction, and inter-trial crossings. Z-DEVD-FMK did not impair working memory in the spontaneous alternation behavior paradigm. Z-DEVD-FMK affected neither emotionality nor locomotor activity in the open-field test. It also did not influence behavior in the light-dark chamber. Measurement of caspase-3 activity in rat brain regions involved in active avoidance learning revealed z-DEVD-FMK-related inhibition of the enzyme activity most pronounced (about 30%) in the fronto-parietal cortex; a similar effect was close to significant in the hippocampus. The results suggest the involvement of brain caspase-3 in selected forms of learning.

[Statistical indices in medicine and epidemiology and their classification].

Mathematical statistics deals with abstract notions, while medicine solves complicated and many-sided problems. For this reason medical statistics faces some moot points in the interpretation of a number of notions and the classification of statistical indices. In the present article the definition of variables and statistical indices is formulated and their characterization is given. An attempt is made to provide the systematization and natural classification of the latter. Statistical indices are defined as the characteristics of statistical totalities. To classify statistical indices, the most essential signs are used: the character of a variable (external relations), the trend of study (internal content), the form of expression (calculation), derived indices and characteristics (comparison and the results of analysis).

[Pentylenetetrazole kindling induces caspase-3 activation in rat brain]. / Pentilentetrazolovyi kindling vysyvaet aktivatsiiu kaspazy-3 v mozge krys.

Pentylenetetrazole kindling (but not a single pentylenetetrazole injection) induced caspase-3 activation in the cerebral cortex, hippocampus, and cerebellum of rats as well as neurodegeneration in the hippocampus. The number of neurons in the CA3 subfield of the hippocampus decreased significantly, whereas no apoptotic nuclei could be detected. The results support a possible non-apoptotic involvement of caspase-3 in brain plasticity.

[Caspase-3 inhibition blocks long-term potentiation in hippocampal slices]. / Ingibirovanie kaspazy-3 blokiruet dlitel'nuiu potentsiatsiiu v srezakh gippokampa.

Incubation of hippocampal slices with Z-DEVD-FMK, a specific inhibitor of caspase-3, elicits a time dependent decrease in long-term potentiation (LTP). After 4 hours or later after the incubation with Z-DEVD-FMK the tetanization fails to induce LTP. However, Z-DEVD-FMK does not affect basal indices of synaptic plasticity and short-term plasticity (population spike amplitudes and paired pulse facilitation). The results are the first evidence for the involvement of caspase-3-mediated mechanisms in long-term potentiation phenomenon.

[The frequency of antibodies against delta virus in patients with HBs positive hepatitis]. / Chastota antitel k del'ta-virusu u bol'nykh HBs-pozitivnym gepatitom.

Patients with HBsAg-positive hepatitis were screened for antibodies to HDV and HCV. The incidence of anti-HDV was 12.5% in a sample of 265 patients. The values differed appreciably in men and women, patients with chronic and acute hepatitis, narcomaniacs and subjects taking no narcotics. Antibodies to HDV were more incident in anti-HCV-positive than in anti-HCV-negative patients. The age-specific structure of the sampling has been analyzed and the distribution of HDV, HCV, narcomania, and chronic hepatitis markers for age groups has been determined. A high incidence of mixed (double and triple) infections with hepatotropic viruses has been revealed.

[Morbidity: terminology, mechanisms of formation and classification]. / Zabolevaemost': terminologiia, mekhanizmy formirovaniia i klassifikatsiia.

In the 70-ies of the last century the evolution of the epidemic process doctrine resulted in developing population approach to morbidity analysis, in addition to the traditional focal approach. On the one hand, this led to the discussion on the possibility of applying such notion to non-infectious diseases and, on the other hand, to the discussion on the mechanisms of the development and formation of different manifestations in infectious diseases. In both cases the discussion was centered on the phenomenon of morbidity. The present article deals with the nature of morbidity as a phenomenon and the acceptability of general scientific approaches in the interpretation of seasonal and cyclic character of morbidity from the viewpoint of the wave process in an open system. On the basis of the data presented in this work the terms used in epidemiology in considering manifestations of the epidemic process are discussed. The improved classification of morbidity by qualitative and quantitative signs for infectious diseases is proposed.

[Streptococcal respiratory infection in large organized children's collectives and experience in optimizing its prevention]. / Respiratornaia streptokokkovaia infektsiia v krupnykh organizovannykh detskikh kollektivakh i opyt optimizatsii ee profilaktiki.

Epidemiological analysis of the manifestations of respiratory streptococcal infection in the all-year-round pioneer camp "Ocean" over 1984-1990 and in similar large organized groups of children revealed some common regularities manifested as consecutively repeating morbidity rises in acute respiratory diseases, tonsillitis, scarlet fever over a year (rotations 1-3 and 9). Time course of the disease incidence over each rotation (month) had a specific pattern as well. Trials of our newly developed system of prevention and treatment with tomicid showed its high effectiveness, which manifested by a drop in the morbidity level and changes in the structure and dynamics of respiratory streptococcal infection.

[The manifestations of an epidemic process in a respiratory streptococcal infection among ships' crews under commercial sailing conditions]. / Proiavleniia épidemicheskogo protsessa respiratornoi streptokokkovoi infektsii sredi ékipazhei sudov v usloviiakh promyslovogo reisa.

Morbidity in respiratory streptococcal infection in 6 ships of the State Fishery Amalgamation "Dal'ryba" during 8 voyages was analyzed. During voyages morbidity rate is determined by sporadic cases, seasonal rises at the time of the voyage and epidemic outbreaks. Spring and summer months constitute the period of risk for seasonal morbidity rises during voyages and epidemic outbreaks at the time of the formation of the crew. The minimal size of the crew in which the activation of the epidemic process took place was 350 persons. In lesser crews (250-300 persons) seasonal rises in morbidity were observed only in the presence of frequent and intensive change-over of crew members.

[Relation between the renin-angiotensin and kallikrein-kinin systems of the blood during physical loading of hypertension patients]. / Sootnoshenie renin-angiotenzinnoi i kallikrein-kininovoi sistem krovi pri fizicheskoi nagruzke u bol'nykh gipertonicheskoi bolezn'iu.

Blood angiotensin-converting enzyme, renin, kallikrein and prekallikrein ratios were investigated in 61 essentially hypertensive patients at rest and during rationed exercise. Biochemical findings were compared with major parameters of systemic hemodynamics measured under the same conditions. Grouping of patients on the basis of renin activity was mirrored in different levels of the angiotensin-converting enzyme and kallikrein: increased renin activity was accompanied by the activation of the said enzymes, and reduced activity, by their suppression. Rationed exercise did not produce noticeable kallikrein-kinin shifts in hypertensive patients, their renin-angiotensin response depending on the baseline. The markedness of hemodynamic change in response to exercise differed in patients with different humoral background.

[Changes in the activity of enzymes of renin-angiotensin and kinin systems in the rat brain after adrenalectomy and administration of hydrocortisone]. / Izmenenie aktivnosti fermentov renin-angiotenzinovoi i kininovoi sistem mozga krys v usloviiakh adrenaléktomii i vvedeniia gidrokortizona.

It is shown that the activity of enzymes participating in renin-angiotensin and brain kinin systems' metabolism depends on functional state of hypothalamo-pituitary-adrenocortical system. Under experimental hypocorticism the activity of angiotensin-converting enzyme and kininase I in the hypothalamus, hippocamp, corpus striatum and rat pituitary decreases; the renin-like enzyme activity decreases in the corpus striatum but increases in the hypothalamus and hippocamp. After hydrocortisone administration to adrenalectomized rats the angiotensin-converting enzyme activity of the hippocamp and pituitary is shown to be normalized as well as renin-like enzyme and kininase I of the hippocamp and corpus striatum. The activity of the studied enzymes in the hypothalamus decreases in this case.

[Content of arachidonic acid metabolites in blood and saliva of children with bronchial asthma]. / Soderzhanie metabolitov arakhidonovoi kisloty v krovi i sliune detei s bronkhial'noi astmoi.

The rise of the thromboxane B2, leukotriene B4 and prostaglandin F2a concentration in the blood and saliva of children was revealed during the attack of the bronchial asthma. At the same time the content of the prostaglandin E2 and prostacyclin in these biological fluids was reduced. The level of the eicosanoids in the examined liquids was correlated with the severity of bronchial asthma proceeding and with the adrenal glands function, which activity was also reduced.

[Clinical characteristics of the course of acute viral hepatitis B in middle-aged and aged patients]. / Klinicheskie osobennosti techeniia ostrogo virusnogo gepatita B u lits pozhilogo i starcheskogo vozrasta.

The clinical manifestations of acute virus hepatitis B were studied and compared in 109 elderly and senile patients (group I) and in 103 young patients (group II). In all the patients, the clinical diagnosis was confirmed by HBsAg demonstration in the peripheral blood. It was established that hepatitis B ran a severe and medium-severe course in 93.5% of the group I patients. In severe hepatitis B, intoxication was marked in 44.6% of the group I and in 65.3% of the group II patients. In group I, it was more prolonged reaching on an average 21 +/- 2 days versus 13 +/- 3 days in group II. The liver increased by 4 cm and more in 27.52% of the group I patients and in 9.71% of the group II patients. In the group I patients, the liver size returned to normal by the discharge from hospital less frequently than in the group II patients whatever the disease severity. Splenomegaly was noted in 6.42% of the group I patients only with a severe hepatitis B, and in 23.3% of the group II patients. In the group I patients with a severe hepatitis B, bilirubinemia reached a maximum at the eleventh day of jaundice or later (71.4%). In 64.3% of the group II patients, the maximum was seen within the first ten days of jaundice. In the group I patients, more severe disease patterns correlated with more marked hyperfermentemia ALAT (31.7 +/- 1.59 mmol/h.l. in a severe pattern, 26.9 +/- 1.29 mmol/h.l. in a medium-severe pattern). In the group II patients, no relationship was found between the degree of hyperfermentemia and disease severity.

[Relationship between chronic viral hepatitis and hepatocellular carcinoma]. / Sviaz' khronicheskogo virusnogo gepatita i gepatotselliuliarnogo raka.

Recent years have seen a correlation between the rise in morbidity and lethality from chronic viral hepatitis and that of hepatocellular carcinoma. Present-day methods of hepatotropic viruses (HBV and HCV) identification point to a growing role of chronic viral hepatitis in etiology of cirrhosis which gives rise to hepatocellular cancers. A study of 49 cases based on sectional material established hepatocellular carcinoma development in smoldering chronic viral hepatitis caused by B or C virus or their combination. An immunohistochemical investigation (29) identified differences in hepatitis B and C virus antigen expression in tumor and adjacent hepatic tissue.